- Potential benefitReduces improper payments by identifying deceased providers who may still be billing Medicaid.
- Potential benefitDeters fraud and abuse through recurring verification of provider existence and status.
- Potential benefitImproves enrollment and claims data integrity by keeping provider rosters current.
Medicare and Medicaid Fraud Prevention Act
Referred to the House Committee on Energy and Commerce.
This bill amends the Social Security Act to require States, beginning January 1, 2027, to check the Death Master File when enrolling or revalidating Medicaid providers and to run that check at least quarterly while a provider remains enrolled. The requirement is added as an additional provider screening condition under Medicaid provider enrollment rules.
Support common for fraud prevention; liberals emphasize program integrity.
Relative to its intended legislative type, this bill specifies a discrete administrative obligation (quarterly Death Master File checks for enrolled Medicaid providers) with clear timing and an identified responsible party, but it lacks implementation detail on follow-up actions, funding, data-matching procedures, edge-case handling, and accountability mechanisms.
This bill amends the Social Security Act to require States, beginning January 1, 2027, to check the Death Master File when enrolling or revalidating Medicaid providers and to run that check at least quarterly while a provider remains enrolled.
The requirement is added as an additional provider screening condition under Medicaid provider enrollment rules.
Content is narrow, non-ideological, and administratively plausible—favorable for passage—but practical implementation costs and legislative priorities temper odds.
Relative to its intended legislative type, this bill specifies a discrete administrative obligation (quarterly Death Master File checks for enrolled Medicaid providers) with clear timing and an identified responsible party, but it lacks implementation detail on follow-up actions, funding, data-matching procedures, edge-case handling, and accountability mechanisms.
Support common for fraud prevention; liberals emphasize program integrity.
Who stands to gain, and who may push back.
These are examples from the analysis, not a ranked list of the most-affected groups.
- StatesIncreases administrative and IT costs for states to implement and maintain quarterly checks.
- Federal agenciesCould function as an unfunded federal mandate if no implementation funding is provided.
- Potential burdenRisk of false matches or data errors could wrongly deactivate legitimate providers temporarily.
Why the argument around this bill splits.
Support common for fraud prevention; liberals emphasize program integrity.
Likely supportive because it strengthens program integrity and reduces payments to deceased providers.
May want safeguards to prevent wrongful provider removals and ensure equitable implementation funding.
Generally favorable as a targeted anti-fraud measure, but wants clarity on costs, operational details, and safeguards.
Would favor modest implementation funding and standards to reduce errors.
Mixed: supports fraud prevention and stopping payments to deceased providers, but wary of new federal mandates on states and unfunded costs.
Concerned about data access and federal overreach.
The path through Congress.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Content is narrow, non-ideological, and administratively plausible—favorable for passage—but practical implementation costs and legislative priorities temper odds.
- State administrative cost and burden estimates absent
- Access rules, fees, or licensing for the Death Master File
Recent votes on the bill.
No vote history yet
The bill has not accumulated any surfaced votes yet.
Go deeper than the headline read.
Support common for fraud prevention; liberals emphasize program integrity.
Content is narrow, non-ideological, and administratively plausible—favorable for passage—but practical implementation costs and legislative…
Relative to its intended legislative type, this bill specifies a discrete administrative obligation (quarterly Death Master File checks for enrolled Medicaid providers) with clear timing and an identified responsible pa…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.